| Organization Name: | ST CHARLES HEALTH COUNCIL INC |
| NPI Number: | 1942322003 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MALCOLM PERDUE (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 815 4a Laurel Avenue Coeburn |
| State: | VA US |
| Postal Code: | 24230 |
| Phone Number: | 2765652764 |
| Fax Number: | 2763956990 |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |